This blog is totally independent, unpaid and has only three major objectives.
The first is to inform readers of news and happenings in the e-Health domain, both here in Australia and world-wide.
The second is to provide commentary on e-Health in Australia and to foster improvement where I can.
The third is to encourage discussion of the matters raised in the blog so hopefully readers can get a balanced view of what is really happening and what successes are being achieved.

Sunday, July 24, 2011

Some Thoughts On the Reactions to Senator Boyce’s Comments on NEHTA and the PCEHR.

It has now been a few days since we noted Senator Sue Boyce’s remarks on NEHTA and DoHA’s plans for the PCEHR.

The National eHealth Transition Authority has responded to the no-holds barred attack it faced yesterday from Queensland Senator Sue Boyce who accused it of poor progress in terms of delivering an electronic health platform for all Australians, and also called into question the value of a personal controlled electronic health record (PCEHR).

Nehta said yesterday that it wanted to carefully review what Senator Boyce had said before responding.

The Personally Controlled Electronic Health Record – which has secured Government funding of more than $466 million – could be scrapped by a Liberal Government. Senator Sue Boyce, Liberal Senator for Queensland, used a speech at a Sydney health administration conference today to claim there was no established evidence-based case for the benefits of a PCEHR; attack the National eHealth Transition Authority; and, brand much of the Government investment made to date in e-health initiatives a waste of taxpayer money.

Saturday, July 23, 2011

Crazy plan to computerize medical records nationwide

This is an absolute lulu. Big new computer programs generally do not work and Queensland health can't even get its payroll software working after over a year of trying. And the Brits had a similar medical records plan -- on which they spent OVER 12 BILLION POUNDS before they gave up on it after many years of trying to get it to work

THE Opposition has called on the Gillard government to hit the pause button on the $467 million electronic health records project until a "thorough assessment" on e-health is conducted.

The call comes less than 12 months from the roll out of the opt-in, personally controlled e-health record (PCEHR) system.

In a vitriolic speech, Queensland Liberal Senator Sue Boyce ironed out what she described as "failures" in e-health implementation over the years. She gave participants at a health administration conference in Sydney a history lesson on public sector e-health initiatives since the late 1990s during the Howard era and vowed to share what "needs to happen next".----

From NEHTA we have the following as reported by Beverley Head (link above).

“This morning a Nehta spokesperson without directly referring to the Senator’s speech said the organisation’s programme; “To support a connected health system for Australia is both ambitious and achievable. It’s been forecast that by 2020 the improvements we’re working towards will save at least 5,000 lives and $7.6 billion each year across Australia.

“We’re confident about delivering a world leading Personally Controlled Electronic Health Record system and we have a skilled and committed team working very hard to make sure this happens.”

And we have comments from Acting Health Minister Mark Butler reported by Fran Foo in The Australian (link above also).

----- Begin Extract

“Acting federal Health Minister Mark Butler said it was interesting that Senator Boyce was criticising a governance model created by Mr Abbott.

"There's one thing that Senator Boyce and Tony Abbott are united on however -- they want to cut all funding for e-health from the budget," Mr Butler said.

"If funding is cut, patients will miss out on the huge benefits that e-health records will bring.

"As Senator Boyce should know (since she was there), NEHTA is appearing at Senate estimates committee hearings," he said.

Senator Boyce said in her view: "what a Coalition government needs to do is thoroughly review the purpose of a national e-health system before committing another cent".

"It seems to me that the providers' needs and the consumers' needs, especially taking into account privacy concerns, are unlikely to be met by the same universal system ... interfacing systems may be the answer.

"There will be patients who are prepared to sacrifice privacy in return for the convenience of a single repository of their entire medical history, but not all," she said.

Mr Butler said the government had released a draft Concept of Operations and a draft legislative issues paper, "both of which set out very strong privacy protections as part of this patient controlled system".

He said the Senator's comments were misleading. "This will not be one single repository for information as Senator Boyce misleadingly says. Maybe she should go back and do her homework before her next speech".

----- End Extract

Senator Boyce has provided further text relating to her remarks of last Monday to address the area of what she is hoping to see going forward. I quote (with permission):

“In my view, what a Coalition Government needs to do is thoroughly review the purpose of a national e-health system before committing another cent.

It seems to me that the providers’ needs and the consumers’ needs, especially taking into account privacy concerns, are unlikely to be met by the same universal system. Interfacing systems may be the answer.

There will be patients who are prepared to sacrifice privacy in return for the convenience of a single repository of their entire medical history, but not all.

We also need to clarify if it is technically possible to develop a system that enables all data to be collected in a patient controlled record. NeHTA says yes, but many experts in the field say no. Certainly a system that allows the results of a GP consultation to be uploaded into a PCEHR doesn’t currently exist.

My biggest concern is the current structure of NeHTA and ensuring that any ‘son of NeHTA’ is not structured the same way.

The Board of NeHTA is currently all the secretaries of the jurisdictional Health departments. An independent chair, David Gonski, has been appointed as a nod towards the lack of commercial experience amongst the other directors.

I would prefer to see a Board similar in structure to AIHW with a mix of stakeholder and government appointees.

The Board also needs to be accountable to “someone” other than COAG. NeHTA should be required by law, not ministerial whim, to be accountable to Parliament, through appearances at Senate Estimates, and it should be subject to the Freedom of Information Act.

The answer to getting an e-health system ready to “burst out the front door” will not be easy but it starts with accountability and transparency.”

----- End Quote.

What to make of all this.

From my perspective I have been saying for years that NEHTA is appallingly unaccountable and so certainly would welcome any Opposition move to improve NEHTA’s governance as was recommended both by Deloittes and the Boston Consulting Group. (Note there is still not one member of the NEHTA board who is an acknowledged e-Health expert!)

It is really pleasing Senator Boyce recognises the fundamental importance of governance in the overall success of e-Health initiatives.

It is also pleasing to see the idea of the differing needs of consumer and professional systems being picked up in both sets of documentation. I explored this issue a week or so ago here:

On the basis that NEHTA is essentially the monkey to the organ grinder of the Commonwealth Department as far as the PCEHR is concerned, (DoHA has control of the funds!) it would seem sensible for DoHA to engage with Senator Boyce sooner rather than later to properly understand what is needed to obtain bi-partisan support. Without this an already imperilled program is utterly doomed!

David.

ps. If you haven’t looked at the comments on PCEHR and Standards you may find the views expressed interesting:

1 comment:

Anonymous
said...

Let's face the facts. The Liberal Government and DOHA would not accept they were going about it the wrong way. The incumbent Labor Government and DOHA will not accept they too are going about it the wrong way. 10 years virtually wasted along with hundreds of millions of dollars.

The Ministers' advisers are the bureaucrats in the Department of Health & Ageing. The only constant in this whole terrible mess over the last decade is the Departmental Secretary. Therein lies the rub.

She has met with and been advised by some excellent people who know what they are talking about. She has spoken with them and received their written advice. She has not heeded their advice and she clearly has no intention of doing so now. Had she heeded their advice (and I will not name them here) we would all be very much further ahead and not wallowing in this sewer-like mess which she has allowed NEHTA and DOHA to create and which they will continue creating in the unfounded yet conceited belief they alone have all the answers.